Prescribing Pattern and Cost Analysis on (Dmard's) Disease Modifying Anti Rheumatoid Drugs in Rheumatoid Arthritis Patients of a Tertiary Care Teaching Hospital in South India - a Cross Sectional Study.

Abstract

To study the current prescription pattern and to analyze the cost of the treatment prescribed to RA patients referred to orthopedics OPD in a tertiary care teaching hospital of South India. The study protocol was approved by the institutional ethics committee. Patients attending Orthopedic OPD for existing RA disease were recruited as per inclusion criteria. Written informed consent was sought. Total 100 consecutive rheumatoid arthritis patients (fulfilling the American College of Rheumatology Criteria 1987) were recruited during study period. Study Design: Cross-sectional study. Study Duration: 06 Months (From July 1st to December 31st 2014) Study Site: Department of Orthopedics, Government Medical College and Hospital, Anantapuramu, Andhra Pradesh, India. Majority of patients (67%) in the study population were on combination of two DMARDs. Most frequently prescribed two DMARDs combination was methotrexate and hydroxychloroquine (64%). Average total cost per prescription was found to be 763.39□, while average hospital and out of pocket expense were 281.12□ and 482.88□ respectively. The drug use pattern in RA was found to be DMARDs based and majority of the cost was borne by the patient. The total increase in cost was due to administration of drugs to treat the adverse drug reaction. Prospective studies in a larger number of patients are needed to assess the utility of prescription audit and cost analysis of drugs used in RA.